By Paul Hemsley

At the 2012 Health and Productivity Management Congress in Sydney, Dame Carol Black issued a new prescription for the UK health system that aims to treat workplace absence from illness and its economic side effects.

Australians may claim the institution of the ‘sickie’ as their own, but it’s an international malady that equally causes pain for British workplaces and damages their economy.

A well-entrenched problem, productivity losses from bad health among British employees is one exacerbated by stubborn attitudes and false perceptions on what constitutes good health.

Ailing workforces don’t come cheap either. Employers in the UK now pay £9 billion annually in sick pay and associated costs, while the state spends £13 billion annually on health-related benefits.

Those figures are just a fraction of the overall £100 billion Her Majesty’s Government spends annually on health, placing an enormous strain on the taxpayer.

While employers bear the immediate costs of short term sickness, it is the state that ultimately absorbs the cost of longer term ill-health. More than 300,000 people leave work to claim sicknessrelated benefits each year, around half of the total take for Employment and Support Allowance (ESA).

Such levels have ministers worried that the UK simply can’t afford a ‘vicious cycle’ of further health and welfare services for those out of work because of the negative consequences of poverty on deteriorating health.

So when the HM Government decided to intervene, it called in UK National Director for Health and Work, Dame Carol Black and British diplomat David Frost to assess the problem and come up with workable solutions.

Their goal was to explore radical new ways on how the current system can be changed to help more people stay in work and reduce costs for employers and the government.

Together they wrote a report “Health at work – an independent review of sickness absence” for the UK Department of Work and Pensions and the Department for Business Innovation and Skills.

Published in November 2011, the report recommended educating managers to recognise health matters, changing organisational culture, community outreach and making personnel interested in health.

A long-time crusader for better health management in the home and the workplace, Dame Carol had previously compiled reports on Britain’s working age population.

Speaking in August at the Health and Productivity Management Congress in Sydney, Dame Carol was frank about her role in managing changes in health for both the public and private sector.

Getting employees to engage and become interested in their own health is one of the most important steps, Dame Carol says, telling Government News the biggest issue is engaging workers on their own health and fitness while creating programs to meet the needs of a diverse population.

The public sector can learn from the private sector on how to implement good management in health, Dame Carol says.

“Some of our big private companies do a jolly good job of looking after their staff and giving quite a lot to the community,” Dame Carol says.

But differences in how public and private organisations approach their work creates a discrepancy in attitudes on whether spending on employee health is even worth it.

Dame Carol says it’s more difficult to engage the public sector on spending money on health because it’s too careful and has difficulty seeing value in supporting worker fitness.

“[As a practical example], the National Health Service has had a big dilemma where the [chief executive] of a hospital asks ‘should I really be spending and investing money in the health of a staff?’” she says.

She says senior managers ask what patients and their relatives will think if they knew money was being spent on staff health rather than the patients.

“I think that’s a bit silly because if I am a patient, I would like the staff that looks after me to be healthy and well and engaged at work.

“I don’t think the public would mind but the perception at home is ‘goodness me, we’re spending public money, perhaps inappropriately’,” Dame Carol says.

One barrier is explaining to the public sector that when they do invest in worker health, they get a return on that investment through raised productivity and lower costs of absenteeism, she says.

Differences in attitude between public and private sectors stem from the fact that the commercial sector values worker efficiency to ensure its profits.

“In the public sector, they’re not driven in quite the same way to think about the product as they’re not making a profit. Dame Carol notes the motivations for why people work vary. “Most people who do work in health are there because they want to give something … to society.”

Organisations in the UK tend to shy away from health issues because employers often told employees their health was a private matter, according to Dame Carol.

She warns that the attitude of “your health is not my concern as your employer” must change.

“Many employers used to say to me that the employee won’t want them to be interested in their health…on the grounds of running a tight ship,” she says.

Dame Carol describes government as a rigid culture that wants “quick wins” and doesn’t see an electoral victory resulting from changing organisational attitudes to suit the wellbeing of employees.

“You’re really trying to change some pretty strongly held attitudes. You’ve got to change the culture, you’ve got to get people to think differently.

“They want things they can show next year or six months and I think this particular agenda is not that quick,” Dame Carol cautions, noting that political cycles don’t incentivise governments to make the change.

Another issue is breaking siloed structures. She says one of her jobs is to get departments to talk to and work with each other, but limited budgets impede agreements on the money each will contribute to internal health reform. “I think there hasn’t been a culture of cross-government working,” she says.

If reforms aren’t implemented to decrease worker absenteeism from sickness, a domino effect will occur because of people out of work depending on welfare, which is unsustainable for the government, according to Dame Carol.

She argues that workplace personnel have been conditioned to believe that they are either 100 per cent well or 100 per cent unwell, resulting in doctor’s certificates becoming a self-fulfilling prophecy of perpetual illness for the sick worker.

She says people are living longer because infection has largely disappeared but they are likely to get chronic diseases earlier in life.

“I think instead of having people fit enough to work longer, the irony will be we’re living longer,” Dame Carol says.

While people need to work longer through the course of their lives, ensuing diseases mean that they contribute less to the economy because “they’re just not that well”.

“That will have an awful effect on the health bill. It will cost us more money on health, but it will also mean that people are not at work so they’re not paying taxes and they may be in our benefit system which it not a good place,” she says.

“I don’t know why we haven’t thought of the workplace before because in a way that’s where we spend 60 per cent of our time if we’re working.”